Risk markers for fatal and non-fatal prescription drug overdose: a meta-analysis
Abstract Background Drug overdose is a public health crisis in the United States, due in part to the unintended consequences of increases in prescribing of opioid analgesics. Many clinicians evaluate risk markers for opioid-related harms when prescribing opioids for chronic pain; however, more data...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2017-08-01
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| Series: | Injury Epidemiology |
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| Online Access: | http://link.springer.com/article/10.1186/s40621-017-0118-7 |
| _version_ | 1811210763839209472 |
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| author | Joanne E. Brady Rebecca Giglio Katherine M. Keyes Charles DiMaggio Guohua Li |
| author_facet | Joanne E. Brady Rebecca Giglio Katherine M. Keyes Charles DiMaggio Guohua Li |
| author_sort | Joanne E. Brady |
| collection | DOAJ |
| description | Abstract Background Drug overdose is a public health crisis in the United States, due in part to the unintended consequences of increases in prescribing of opioid analgesics. Many clinicians evaluate risk markers for opioid-related harms when prescribing opioids for chronic pain; however, more data on predictive risk markers are needed. Risk markers are attributes (modifiable and non-modifiable) that are associated with increased probability of an outcome. This review aims to identify risk markers associated with fatal and non-fatal prescription drug overdose by synthesizing findings in the existing peer-reviewed and grey literature. Eligible cohort, case-control, cross-sectional, and case-cohort studies were reviewed and data were extracted for qualitative and quantitative synthesis. Findings Summary odds ratios (SOR) were estimated from 29 studies for six risk markers: sex, age, race, psychiatric disorders, substance use disorder (SUD), and urban/rural residence. Heterogeneity was assessed and effect estimates were stratified by study characteristics. Of the six risk markers identified, SUD had the strongest association with drug overdose death (SOR = 5.24, 95% confidence interval (CI) = 3.53 - 7.76), followed by psychiatric disorders (SOR = 3.94, 95% CI = 3.09 - 5.01), white race (SOR = 2.28, 95% CI = 1.93 - 2.70), the 35-44 year age group relative to the 25-34 year reference group (SOR = 1.52, 95% CI = 1.31 - 1.76), and male sex (SOR = 1.33, 95% CI = 1.17 - 1.51). Conclusions This review highlights fatal and non-fatal prescription drug risk markers most frequently assessed in peer-reviewed and grey literature. There is a need to better understand modifiable risk markers and underlying reasons for drug misuse in order to inform interventions that may prevent future drug overdoses. |
| first_indexed | 2024-04-12T05:01:09Z |
| format | Article |
| id | doaj.art-348b763fa15444049cda66d39e21ad59 |
| institution | Directory Open Access Journal |
| issn | 2197-1714 |
| language | English |
| last_indexed | 2024-04-12T05:01:09Z |
| publishDate | 2017-08-01 |
| publisher | BMC |
| record_format | Article |
| series | Injury Epidemiology |
| spelling | doaj.art-348b763fa15444049cda66d39e21ad592022-12-22T03:47:00ZengBMCInjury Epidemiology2197-17142017-08-014112410.1186/s40621-017-0118-7Risk markers for fatal and non-fatal prescription drug overdose: a meta-analysisJoanne E. Brady0Rebecca Giglio1Katherine M. Keyes2Charles DiMaggio3Guohua Li4Department of Epidemiology, Columbia University Mailman School of Public HealthCenter for Injury Epidemiology and Prevention, Columbia UniversityDepartment of Epidemiology, Columbia University Mailman School of Public HealthDepartment of Surgery, Division of Trauma, New York UniversityDepartment of Epidemiology, Columbia University Mailman School of Public HealthAbstract Background Drug overdose is a public health crisis in the United States, due in part to the unintended consequences of increases in prescribing of opioid analgesics. Many clinicians evaluate risk markers for opioid-related harms when prescribing opioids for chronic pain; however, more data on predictive risk markers are needed. Risk markers are attributes (modifiable and non-modifiable) that are associated with increased probability of an outcome. This review aims to identify risk markers associated with fatal and non-fatal prescription drug overdose by synthesizing findings in the existing peer-reviewed and grey literature. Eligible cohort, case-control, cross-sectional, and case-cohort studies were reviewed and data were extracted for qualitative and quantitative synthesis. Findings Summary odds ratios (SOR) were estimated from 29 studies for six risk markers: sex, age, race, psychiatric disorders, substance use disorder (SUD), and urban/rural residence. Heterogeneity was assessed and effect estimates were stratified by study characteristics. Of the six risk markers identified, SUD had the strongest association with drug overdose death (SOR = 5.24, 95% confidence interval (CI) = 3.53 - 7.76), followed by psychiatric disorders (SOR = 3.94, 95% CI = 3.09 - 5.01), white race (SOR = 2.28, 95% CI = 1.93 - 2.70), the 35-44 year age group relative to the 25-34 year reference group (SOR = 1.52, 95% CI = 1.31 - 1.76), and male sex (SOR = 1.33, 95% CI = 1.17 - 1.51). Conclusions This review highlights fatal and non-fatal prescription drug risk markers most frequently assessed in peer-reviewed and grey literature. There is a need to better understand modifiable risk markers and underlying reasons for drug misuse in order to inform interventions that may prevent future drug overdoses.http://link.springer.com/article/10.1186/s40621-017-0118-7AccidentsAnalgesicsOpioid/toxicityDrug overdoseMortalityPrescription drugs/toxicity |
| spellingShingle | Joanne E. Brady Rebecca Giglio Katherine M. Keyes Charles DiMaggio Guohua Li Risk markers for fatal and non-fatal prescription drug overdose: a meta-analysis Injury Epidemiology Accidents Analgesics Opioid/toxicity Drug overdose Mortality Prescription drugs/toxicity |
| title | Risk markers for fatal and non-fatal prescription drug overdose: a meta-analysis |
| title_full | Risk markers for fatal and non-fatal prescription drug overdose: a meta-analysis |
| title_fullStr | Risk markers for fatal and non-fatal prescription drug overdose: a meta-analysis |
| title_full_unstemmed | Risk markers for fatal and non-fatal prescription drug overdose: a meta-analysis |
| title_short | Risk markers for fatal and non-fatal prescription drug overdose: a meta-analysis |
| title_sort | risk markers for fatal and non fatal prescription drug overdose a meta analysis |
| topic | Accidents Analgesics Opioid/toxicity Drug overdose Mortality Prescription drugs/toxicity |
| url | http://link.springer.com/article/10.1186/s40621-017-0118-7 |
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